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Thromb Haemost 2016; 115(04): 864-868
DOI: 10.1160/TH15-07-0589
Atherosclerosis and Ischaemic Disease
Schattauer GmbH

Stem cell mobilisation by granulocyte-colony stimulating factor in patients with acute myocardial infarction

Long-term results of the REVIVAL-2 trial
Birgit Steppich
1   Deutsches Herzzentrum der Technischen Universität München, München, Germany
,
Martin Hadamitzky
1   Deutsches Herzzentrum der Technischen Universität München, München, Germany
,
Tareq Ibrahim
2   Klinikum rechts der Isar, 1. Medizinische Klinik, München, Germany
,
Philip Groha
1   Deutsches Herzzentrum der Technischen Universität München, München, Germany
,
Heribert Schunkert
1   Deutsches Herzzentrum der Technischen Universität München, München, Germany
,
Karl-Ludwig Laugwitz
2   Klinikum rechts der Isar, 1. Medizinische Klinik, München, Germany
,
Adnan Kastrati
1   Deutsches Herzzentrum der Technischen Universität München, München, Germany
,
Ilka Ott
1   Deutsches Herzzentrum der Technischen Universität München, München, Germany
,
for the Regenerate Vital Myocardium by Vigorous Activation of Bone Marrow Stem Cells (REVIVAL-2) Study Investigators› Author Affiliations
Further Information

Publication History

Received: 24 July 2015

Accepted after major revision: 22 January 2015

Publication Date:
29 November 2017 (online)

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Summary

Treatment with granulocyte-colony stimulating factor (G-CSF) mobilises cells from the bone marrow to the peripheral blood. Previous preclinical and early clinical trials may suggest that treatment with G-CSF leads to improved myocardial perfusion and function in acute or chronic ischaemic heart disease. In the REVIVAL-2 study we found that stem cell mobilisation by G-CSF does not influence infarct size, left ventricular function and coronary restenosis in patients with acute myocardial infarction (MI) that underwent successful percutaneous coronary intervention. The objective of the present analysis was to assess the impact of G-CSF treatment on seven-year clinical outcomes from the REVIVAL-2 trial. In the randomized, double-blind, placebo-controlled REVIVAL-2 study, 114 patients with the diagnosis of acute myocardial infarction were enrolled five days after successful reperfusion by percutaneous coronary intervention. Patients were assigned to receive 10 μg/kg G-CSF (n=56) or placebo (n=58) for five days. The primary endpoint for this long-term outcome analysis was the composite of death, myocardial infarction or stroke seven years after randomisation. The endpoint occurred in 14.3% of patients in the G-CSF group versus 17.2%> assigned to placebo (p=0.67). The combined incidence of death or myocardial infarction occurred in 14.3%> of the patients assigned to G-CSF and 15.5%> of the patients assigned to placebo (p=0.85). In conclusion, these long-term follow-up data show that G-CSF does not improve clinical outcomes of patients with acute myocardial infarction.

Keywords

Clinical studies - acute myocardial infarction - cardiology - granulocyte-colony stimulating factor - stem cells
 

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